ORIGINAL ARTICLE JBMR Targeted Disruption of Shp2 in Chondrocytes Leads to Metachondromatosis With Multiple Cartilaginous Protrusions Harry KW Kim,1,2 Gen‐Sheng Feng,3 Di Chen,4 Philip D King,5 and Nobuhiro Kamiya1,2 1Texas Scottish Rite Hospital for Children, Dallas, TX, USA 2Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA 3Department of Pathology and Division of Biological Sciences, University of California San Diego, La Jolla, CA, USA 4Department of Biochemistry, Rush University Medical Center, Chicago, IL, USA 5Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA ABSTRACT Metachondromatosis is a benign bone disease predominantly observed in the hands and feet of children or young adults demonstrating two different manifestations: a cartilage‐capped bony outgrowth on the surface of the bone called exostosis and ectopic cartilaginous nodules inside the bone called enchondroma. Recently, it has been reported that loss‐of‐function mutations of the SHP2 gene, which encodes the SHP2 protein tyrosine phosphatase, are associated with metachondromatosis. The purpose of this study was to investigate the role of SHP2 in postnatal cartilage development, which is largely unknown. We disrupted Shp2 during the postnatal stage of mouse development in a chondrocyte‐specific manner using a tamoxifen‐inducible system. We found tumor‐like nodules on the hands and feet within a month after the initial induction. The SHP2‐deficient mice demonstrated an exostosis‐like and enchondroma‐like phenotype in multiple bones of the hands, feet, and ribs as assessed by X‐ray and micro‐computed tomography (CT). Histological assessment revealed the disorganization of the growth plate cartilage, a cartilaginous protrusion from the epiphyseal bone, and ectopic cartilage nodules within the bones, which is consistent with the pathological features of metachondromatosis in humans (ie, both exostosis and enchondroma). At molecular levels, we observed an abundant expression of Indian hedgehog protein (IHH) and fibroblast growth factor 2 (FGF2) and impaired expression of mitogen‐activated protein kinases (MAPK) in the affected cartilage nodules in the SHP2‐deficient mice. In summary, we have generated a mouse model of metachondromatosis that includes manifestations of exostosis and enchondroma. This study provides a novel model for the investigation of the pathophysiology of the disease and advances the understanding of metachondromatosis. This model will be useful to identify molecular mechanisms for the disease cause and progression as well as to develop new therapeutic strategies in the future. © 2014 American Society for Bone and Mineral Research. KEY WORDS: EXOSTOSIS; ENCHONDROMA; CARTILAGE‐SPECIFIC KNOCK‐OUT MOUSE; SHP2; METACHONDROMATOSIS Introduction and feet is the rule in metachondromatosis but is unusual in classic multiple exostoses.(4) In addition, MHE patients do not etachondromatosis (MC, OMIM 156250) is a disorder found develop enchondroma. However, the difference in disease Mprimarily in children or young adults that affects bone mechanisms between metachondromatosis and classic multiple growth, where benign bone tumors produce lumps, mostly on exostoses is unclear. Recently, human genetic studies using the hands and feet. The condition has an autosomal dominant whole genome sequencing and linkage analysis revealed an pattern of inheritance and is characterized by exostoses (ie, a association between germline inactivating mutations of SHP2 (1,2) benign bony growth projecting outward from a bone surface) with metachondromatosis. that commonly affect the bones of the hands and feet Src homology‐2 (SHP2)‐containing protein tyrosine phos- (ie, phalanges and metacarpals/metatarsals) and enchondroma phate, also known as protein‐tyrosine phosphatases nonreceptor of the metaphysis of the long bones and the iliac crest.(1,2) type 11 (PTPN11), plays a central role in RAS/mitogen‐activated Multiple exostoses of the classic type known as multiple protein kinase (MAPK) signaling downstream of several receptor hereditary exostosis (MHE, OMIM 133700)(3) is clinically distinct tyrosine kinases including the epidermal growth factor receptor (5,6) from metachondromatosis because involvement of the hands (EGFR) and fibroblast growth factor receptor (FGFR). In Received in original form April 16, 2013; revised form June 27, 2013; accepted July 19, 2013. Accepted manuscript online August 8, 2014. Address correspondence to: Nobuhiro Kamiya, MD, PhD, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA. E‐mail: [email protected] Additional Supporting Information may be found in the online version of this article. Journal of Bone and Mineral Research, Vol. 29, No. 3, March 2014, pp 761–769 DOI: 10.1002/jbmr.2062 © 2014 American Society for Bone and Mineral Research 761 general, SHP2 promotes RAS/MAPK signal transduction down- 400 base pair for floxed allele and 300 base pair for wild‐type stream of growth factor receptors.(6,7) SHP2 is ubiquitously allele). expressed in the brain in particular(8) and is involved in the differentiation of multiple cell types and in body organization.(9) RNA isolation and real‐time RT‐PCR Homozygous SHP2–/– mice are embryonic lethal at mid‐gestation as a result of multiple defects in gastrulation and mesodermal Total RNA was isolated from the rib cartilage of three patterning.(10) The role of SHP2 in skeletal development, independent mice per group using an RNA isolation kit (Qiagen, however, is largely unknown. In our previous work, we ablated Germantown, MD, USA). cDNA was synthesized using the fi the Shp2 gene postnatally in all somatic cells of the body and SuperScript Preampli cation System (Invitrogen, Carlsbad, CA, fi found multiple skeletal abnormalities including scoliosis, kypho- USA). PCR reactions, data quanti cation, and analysis were ’ sis, osteopetrosis, and growth plate disturbance with cartilage performed according to the manufacturer s standard protocol of abnormalities.(11) Given growth plate disturbances in these the TaqMan gene expression assay using the ABI PRISM 7500 induced SHP2‐deficient mice, we postulated that it would sequence detection system (Applied Biosystems, Rotkreuz, m ‐ be important to specifically investigate the role of SHP2 in Switzerland). The reaction volume was 20 L/well in 96 well ‐ ‐ chondrocytes during postnatal cartilage development and plates. SHP2 (Hs00275784_m1) and control glyceraldehyde 3 remodeling. phosphate dehydrogenase (GAPDH) (Hs99999905_m1) primer/ Although mutations in SHP2 are known to be causative of probe sets were predesigned (Applied Biosystems). All measure- ments were performed in triplicate and analyzed using the metachondromatosis, the pathophysiology of metachondroma- ÀDDC(t) (14) tosis related to the onset and the progression of exostoses in 2 method. hands and feet is still unknown. Further progress in understand- ‐ ing the mechanisms of metachondromatosis is limited by the Gross morphology, radiography, and micro computed availability of human subjects. To understand the pathophysiol- tomography (CT) analysis ogy of the disease and to develop new therapeutic strategies, For gross morphology, photographs of the hands and feet were an animal model for metachondromatosis is much needed. taken immediately after the mice were euthanized. Radiographic The purpose of this study was to investigate the role of SHP2 images of the hands, feet, ribs, and forearms were obtained in chondrocytes. For this purpose, we generated inducible using a Faxitron X‐ray system (Faxitron, Tucson, AZ, USA). For ‐ fi ‐ fi chondrocyte speci c SHP2 de cient mice. Loss of SHP2 in a micro‐CT scan (SkyScan 1172 Micro‐CT, Bruker MicroCT, chondrocytes during the postnatal mouse stage resulted in Kontich, Belgium), each undecalcified specimen was wrapped the development of metachondromatosis. This mouse model with gauze soaked in 70% ethanol and scanned with a 50 kV and will be useful to understand the mechanism of this disease and 200 mA setting and a 0.5‐mm aluminum filter. The resolution was possible means of intervention in pediatric and young adult set to 26.6 microns per pixel, and each rotation step was patients. 0.70 degrees over a range of 180 degrees. After reconstruction with NRecon Reconstruction software (version 1.6.8.), all serial Materials and Methods section grayscale images were set to a threshold to identify the bone that matched the original grayscale X‐ray and to remove ‐ ‐ Generation of chondrocyte specific SHP2 deficient mice any soft‐tissue contribution. The binarized three‐dimensional To delete the Shp2 gene specifically in chondrocytes, we used a images were visualized with CTVox (version 2.4). transgenic mouse line expressing Cre recombinase under the control of the type II collagen promoter (ie, Col2a1CreERt2 mice), Histology and immunostaining which is inducible by tamoxifen administration.(12) We bred the Immediately after euthanization, bones were harvested and fixed Col2a1‐CreERt2 mice with Shp2 floxed (Shp2fx/fx) mice to with 10% formalin for 5 days followed by decalcification with generate experimental Col2a1CreERt2:Shp2fx/fx mice and control 10% EDTA for 5 days. Bones were embedded in paraffin, and 3‐ Shp2fx/fx mice. To induce a gene disruption in vivo, we injected mm sections were prepared. Hematoxylin and eosin (H&E) tamoxifen intraperitoneally into mice at a concentration of 1 mg staining was performed following a standard protocol as per mouse per injection,